Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: A team-level study.
作者研究了领导者的安全行为诚信如何影响团队的安全优先性、心理安全感和患者安全。通过对54个护理团队的调查数据进行路径分析，发现护士长的安全行为诚信与团队的安全优先性和心理安全感正相关。团队安全优先性与上报的治疗错误数量负相关，而心理安全感则正相关。此外，安全优先性和心理安全感对上报错误有交互作用：当心理安全感较高时，安全优先性与错误数量的负相关更强。两者还中介了领导行为诚信与上报错误的关系。结论是，遵守安全规程和承认违反规程的错误对提升患者安全都重要，而领导者言行一致能促进这两方面。
This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety positively relates to both team priority of safety and psychological safety. In turn, team priority of safety and team psychological safety were, respectively, negatively and positively related with the number of treatment errors that were reported to head nurses. We further demonstrated an interaction effect between team priority of safety and psychological safety on reported errors such that the relationship between team priority of safety and the number of errors was stronger for higher levels of team psychological safety. Finally, we showed that both team priority of safety and team psychological safety mediated the relationship between leader behavioral integrity for safety and reported treatment errors. These results suggest that although adhering to safety protocols and admitting mistakes against those protocols show opposite relations to reported treatment errors, both are important to improving patient safety and both are fostered by leaders who walk their safety talk.